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1720004070
WILLIAM K. VANDERWAAL
BLOOMINGTON, IL
NPI
1720004070
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics
(Licence: IL 019-013693)
Enumeration Date
2006-07-13
Last Update Date
2007-07-08
Business Address
Dr. WILLIAM K. VANDERWAAL D.D.S.
2103 E WASHINGTON ST
BLOOMINGTON, IL 61701-4310
Phone number: 309-662-3355
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Mailing Address
Dr. WILLIAM K. VANDERWAAL D.D.S.
2103 E WASHINGTON ST
BLOOMINGTON, IL 61701-4310
Phone number: 309-662-3355
Copy
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